Impact of pharmacist-led order-entry support for patients’ own medications at admission on prescription optimization and physician workload: A single-institution before-and-after study

Abstract Background Task shifting/sharing is increasingly recommended to reduce physicians’ long working hours in Japanese healthcare institutions. Although pharmacist-led order-entry support for patients’ own medications at admission may improve prescription appropriateness and reduce physicians’ workloads, evidence regarding its effectiveness remains limited. This study evaluated the impact of pharmacist-led order-entry support for patients’ own medications at admission on prescription optimization, medication-related incidents, and physician workload at a university hospital. Methods This was a single-institution, before-and-after comparative study. Patients admitted to a 98-bed mixed ward comprising orthopedic surgery, neurology, and neurosurgery departments at Mie University Hospital were included. Outcomes were compared between the pre-implementation (April–September 2022) and post-implementation (April–September 2023) periods. Study outcomes were (1) the monthly number of prescription queries, categorized as prescription errors or pharmaceutical interventions, and the time required for order-entry support; (2) number of medication-related incident reports; and (3) physician perceptions of pharmacist-led order-entry support for patients’ own medications at admission, assessed using a questionnaire. Results A total of 1,295 cases of order-entry support were performed during the 6-month post-implementation period. (1) The total number of monthly prescription queries decreased significantly from 85 to 52 ( p = 0.037). Among them, the number of queries related to pharmaceutical interventions decreased significantly from 36 to 20 ( p = 0.029). The total time required for order-entry support was 2,715 min per month when performed by two pharmacists. (2) The number of medication-related incident reports decreased from 6 to 4, and no contraindicated prescriptions or dosing/unit errors were observed during the post-implementation period. (3) Most surveyed physicians (90.3%) rated the pharmacist-led order-entry support for patients’ own medications on admission as “very useful.” Moreover, 80.6% of physicians reported that the burden of prescription order entry after protocol implementation was “greatly reduced.” The most frequently reported benefit of the intervention was “improved work efficiency” (32.3%), followed by “increased time available for clinical practice” (29.0%) and “reduction in overtime work” (25.8%). Conclusions Pharmacist-led prescription order-entry support for patients’ own medications at admission significantly reduced the number of prescription queries, suggesting improved prescription appropriateness and a potential alleviation of physician workloads.